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Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review

  • Authors:
    • Wei Wang
    • Yingxia Yuan
    • Jiwei Bai
    • Yue Zou
    • Dongxue Zhou
    • Jun Zhao
    • Shuyan Zhang
    • Zishen Wang
    • Jie Wang
    • Jingjing Kong
    • Lu Yang
    • Masashi Mizumoto
    • Hideyuki Sakurai
    • Shosei Shimizu
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, Hebei Yizhou Cancer Hospital, Zhuozhou, Hebei 072750, P.R. China, Pediatric Radiation Therapy Center/Pediatric Proton Beam Therapy Center, Hebei Yizhou Cancer Hospital, Zhuozhou, Hebei 072750, P.R. China, Department of Neurosurgery, Beijing Tiantan Hospital of Capital Medical University, Beijing 100070, P.R. China, Department of Radiotherapy Physics and Technology, Hebei Yizhou Cancer Hospital, Zhuozhou, Hebei 072750, P.R. China, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki 305-8576, Japan
    Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 70
    |
    Published online on: January 16, 2026
       https://doi.org/10.3892/etm.2026.13065
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Abstract

Paragangliomas (PGLs) are rare neuroendocrine tumors with malignant potential that may prove challenging to manage. Those arising at the jugular foramen are particularly problematic, especially if recurring after primary surgical treatment. Long‑term follow‑up is required, and effective treatment options for such recurrences are needed. The present study chronicles a recurring PGL of the jugular foramen that emerged after two surgeries. Alternative therapeutic strategies were accordingly pursued. This account of the related clinical course includes a discussion of the associated literature, focusing on the role of proton beam therapy (PBT) in PGL management and its benefits. The patient under treatment received hypofractionated PBT, utilizing intensity‑modulated proton therapy/pencil‑beam scanning techniques. The prescribed dose was 40 Gy in 15 fractions [equivalent dose in 2‑gy fractions (EQD2), 42.09 Gy, assuming α/β=10) delivered to the gross tumor volume (GTV). Simultaneous integrated boosts to two inner subvolumes [GTV reduced by 2‑mm margin, 50 Gy/15 fractions (EQD2, 55.49 Gy); and GTV reduced by 3‑mm margin, 60 Gy/15 fractions (EQD2, 70.00 Gy)] took place as well. This process ensured precise radiation dosing, while adhering to strict dose constraints for adjacent critical structures. Hence, a quicker therapeutic response (aligned with that of stereotactic radiotherapy principles) was tenable, aiming for both tumor control and clinical improvement. Long‑term follow‑up is imperative to assess outcome durability. The aforementioned events illustrate the potential utility of advanced PBT techniques (namely pencil‑beam scanning, hypofractionated regimens) in managing PGL recurrences of this type, especially if surgical options are limited or carry substantial risks. PBT offers a precise therapeutic alternative, with tumor control capabilities that promise to preserve critical tissues near key locations at the base of the skull.
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Copy and paste a formatted citation
Spandidos Publications style
Wang W, Yuan Y, Bai J, Zou Y, Zhou D, Zhao J, Zhang S, Wang Z, Wang J, Kong J, Kong J, et al: Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review. Exp Ther Med 31: 70, 2026.
APA
Wang, W., Yuan, Y., Bai, J., Zou, Y., Zhou, D., Zhao, J. ... Shimizu, S. (2026). Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review. Experimental and Therapeutic Medicine, 31, 70. https://doi.org/10.3892/etm.2026.13065
MLA
Wang, W., Yuan, Y., Bai, J., Zou, Y., Zhou, D., Zhao, J., Zhang, S., Wang, Z., Wang, J., Kong, J., Yang, L., Mizumoto, M., Sakurai, H., Shimizu, S."Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review". Experimental and Therapeutic Medicine 31.3 (2026): 70.
Chicago
Wang, W., Yuan, Y., Bai, J., Zou, Y., Zhou, D., Zhao, J., Zhang, S., Wang, Z., Wang, J., Kong, J., Yang, L., Mizumoto, M., Sakurai, H., Shimizu, S."Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 3 (2026): 70. https://doi.org/10.3892/etm.2026.13065
Copy and paste a formatted citation
x
Spandidos Publications style
Wang W, Yuan Y, Bai J, Zou Y, Zhou D, Zhao J, Zhang S, Wang Z, Wang J, Kong J, Kong J, et al: Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review. Exp Ther Med 31: 70, 2026.
APA
Wang, W., Yuan, Y., Bai, J., Zou, Y., Zhou, D., Zhao, J. ... Shimizu, S. (2026). Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review. Experimental and Therapeutic Medicine, 31, 70. https://doi.org/10.3892/etm.2026.13065
MLA
Wang, W., Yuan, Y., Bai, J., Zou, Y., Zhou, D., Zhao, J., Zhang, S., Wang, Z., Wang, J., Kong, J., Yang, L., Mizumoto, M., Sakurai, H., Shimizu, S."Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review". Experimental and Therapeutic Medicine 31.3 (2026): 70.
Chicago
Wang, W., Yuan, Y., Bai, J., Zou, Y., Zhou, D., Zhao, J., Zhang, S., Wang, Z., Wang, J., Kong, J., Yang, L., Mizumoto, M., Sakurai, H., Shimizu, S."Postoperative hypofractionated intensity-modulated proton therapy to control recurrent paraganglioma at the jugular foramen: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 3 (2026): 70. https://doi.org/10.3892/etm.2026.13065
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